Archive for March, 2012

I just found a great article with infographics about how the Affordable Care Act will change your individual insurance situation. Right now, the Supreme Court is hearing arguments against many facets of this health care reform act, which has now been in place for 2 years. According to Yahoo! Finance’s Lisa Scherzer, there are 4 main complaints being discussed in the Supreme Court’s hearings. In “How will the affordable care act affect you?,” Scherzer gives examples of how individuals and families will be affected.

The main issue being contested right now is whether or not the government even has the right to force Americans to purchase health insurance. There is also question over whether the individual mandate can be contested now or if the opposition will have to wait until 2015 to fight against it. The Anti-Injuction Act of 1867 says that you cannot fight against a tax before you have actually had to pay the tax. So it’s possible that this mandate requiring everyone to purchase health insurance or be faced with a fine cannot actually be contested until it is in full effect. Many people are wondering if the hundreds of mandates associated with the Affordable Care Act will become null and void if the individual mandate is declared unconstitutional. There is also concern over whether states being forced to expand their Medicaid coverage or lose federal funding for it is violating their sovereignty. There are lots of issues up for debate in the Supreme Court this week.

A 30-year old, healthy woman working full-time but without heath insurance is the first example given. If the ACA takes effect, she will be able to purchase health insurance from a state health insurance exchange because her income is below 400% of the poverty level. She would be able to get insurance for $85/month or risk paying a fine of $695/year starting in 2016. Another example given is for a self-employed 62-year old man who is in poor health. He currently cannot get health insurance because of his pre-existing heart condition, but cannot afford his health care bills or insurance on his $10,000/year salary. Since his income is below 138% of the poverty level, he would be eligible for Medicaid should the ACA take effect. A final example is for a healthy family of 4 who have health insurance through both of their full-time jobs. While their health insurance will not change, their health insurance rates could increase because health insurance companies may be passing costs down. There are many more examples in the original article of how Americans will be affected.

After the Department of Health and Human Services reviewed health insurance rate increases greater than 10%, they have determined that increase requests in 9 states are unreasonable. According to a Department of HHS press release, Secretary Kathleen Sebelius says that the companies either have to reduce the rate increases, refund money to customers, or explain why they aren’t doing either of those things. The Affordable Care Act now requires health insurance companies to justify any health insurance rate increases over 10%. If they cannot do so, the increases will be deemed unreasonable by the government and the insurers will have to make some changes.

The HHS has been reviewing these requests for 6 months now and consumers will be happy to know that health insurance rate increases are on the decline. Increases in premiums went down 4.5% in the last quarter of last year and Nevada health insurance rates actually went down. The government has information on increase requests and other information pertaining to this law on their healthcare website.

The insurance companies whose rate requests were denied were requesting large health insurance premium increases in 9 different states. This would effect 42,000 different people in Wyoming, Wisconsin, Virginia, Nebraska, Montana, Missouri, Louisiana, Idaho and Arizona. Some of these rate increases would have been 24%, believe it or not. But too low a percentage of the increases was actually going to pay for medical costs or improvements in quality, so they were deemed unreasonable. Some states are already showing fewer requests for high rate increases and other states are jumping ahead of the game and purposefully lowering rate increase requests. Check out the government healthcare website for specific information in your state or with your health insurance company.

By 2033, you will likely be paying more money for your health insurance premiums than your total annual income provides. Jenifer Goodwin of Health Day wrote about an Annals of Family Medicine study in the article “Health Insurance Premiums Will Surpass Median Household Income in 2033: Study.” They used data from 2000-2009 and found that health insurance rates increased 8%, while median incomes only increased by 2%. By using those same rates to forecast the future, your health insurance premiums would be about half of your income by 2021 and would cost more than your total income by 2033. The median income in 2009 was just under $50,000.

This study is using the total premium cost for calculations, which does include both the money you contribute as well an any employer contributions. If you have individual health insurance from a company like Aultcare, you pay all of the premium costs yourself anyways. It does not take into account any of your out-of-pocket costs for co-pays, deductibles, or prescriptions. Adding co-pay costs into the equation and taking out employer contributions, health care costs would equal half of the median income by 2031.

In 2005, it was estimated that health insurance rates would be higher than median income by 2025, so there have been a few positive changes. The Affordable Care Act of 2010 looks to decrease some costs. Also, the economic recession is forcing many families to spend less money on their health care. That may not be a good thing overall, but it does lower demand and therefore, healthcare costs. There are many opinions as to what will help this seemingly dire situation and all of them require overhaul of the current practices. Regardless of who pays for these health insurance premiums, we need to make changes to what is covered by health insurance and what can be done to minimize testing and treatment where it is unnecessary.

With record numbers of Americans suffering from arthritis, three drug manufacturers have been trying to get certain arthritis drugs approved by the FDA for years. According to Matthew Perrone of the Associated Press in the article “Arthritis drugs linked to bone decay,” FDA approval won’t be coming any time soon. It has been almost two years since testing was allowed for this experimental drug because of concerns for peoples’ safety. The FDA has found a strong correlation between these nerve-blocking arthritis medications and bone decay. They did find that the side effects were much less common when smaller doses were used.

Pfizer, Johnson & Johnson, and Regeneron Pharmaceuticals meet next week in a public forum to discuss the safety of their arthritis drugs. These particular drugs are nerve growth factor inhibitors. When injected, they block the proteins carrying sensation through the body. In the past, arthritis has been treated with painkillers such as Advil and aspirin. While effective, Advil and other anti-inflammatories can cause bleeding in the stomach and opiates like aspirin are quite addictive. People looking to compare health insurance will likely take into account what drugs will be covered under their plans. Health insurance companies closely follow disputes between the FDA and drug manufacturers to see what drugs they will pay for in their insurance plans.

The FDA is again allowing trials of these drugs to treat cancer pain, but is still banning trials for osteoarthritis. The three drugmakers plan to argue that the side effects almost always occurred in cases where the patient was taking both the nerve growth factor inhibitor and other painkillers. The FDA admits that they found the symptoms to be worse when two drugs were combined, but they found bone problems when Pfizer’s drug wasn’t taken with anything else. Pfizer will likely argue for more testing to be allowed, with the stipulation that patients cannot combine painkillers. They will also stop testing if no improvement is seen after a few doses of the pain medicine.